Affiliation:
1. MD, Consultant Dermatologist, AIMS Hospital, Dombivli (E).
2. Medical Ofcer, Reliance Corporate IT Park, Ghansoli, Navi Mumbai.
Abstract
Nail involvement is an extremely common presentation in people with psoriasis, with life time incidence of nail involvement being 80-90% and is very closely associated with psoriasis vulgaris and psoriatic arthritis. Even though, 5-10% of the cases may have an isolated nail psoriasis, it is usually overlooked. Nail psoriasis has been termed as one of the difficult psoriasis, due to various problems and hurdles experienced during the treatment, like patient tolerance, bioavailability, cost of treatment or longer duration of treatment. Nail psoriasis has a significant psychosocial and economic impact on the life of the patient, as the clinical presentation can not only be painful, but also have a cosmetic disadvantage and cause hindrance in intricate and delicate work. In this review, we discuss about various clinical manifestations and the Nail Psoriasis Severity Index (NAPSI) briefly and explore in depth, the multiple treatment modalities like nail care, topical agents, phototherapy and photochemotherapy, systemic agents and the newer Biological agents and their effectiveness.